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Individual
PAMELA RENEE STACY
Active
Individual
PAMELA RENEE STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP121213
TX
363LA2100X
Acute Care Nurse Practitioner
729458
TX
363LA2100X
Acute Care Nurse Practitioner
AP121213
TX
363LF0000X
Family Nurse Practitioner
Primary
AP121213
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
293825001
—
TX
01
—
75-2616977-007
TRICARE
TX
01
—
75-2616977-066
TRICARE
TX
01
—
75-2616977-118
TRICARE
TX
01
—
752616977042
TRICARE
TX
01
—
867N10
BCBS
TX
Enumeration date
12/29/2011
Last updated
10/28/2022
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